The Role of Potassium in Metabolism: Cellular Mechanisms, Exercise Physiology and Pathophysiological Implications

Review Article

Abstract

Background: Potassium is an intracellular cation and a critical determinant of cellular homeostasis, membrane potential, and metabolic activity. Its tightly regulated distribution between intracellular and extracellular compartments is essential for normal physiological function.

Objective: This review aims to synthesize current knowledge on the role of potassium in metabolic regulation, with emphasis on cellular bioenergetics, acid-base balance, exercise physiology, and the metabolic consequences of hyperkalemia.

Methods: A narrative review of foundational and contemporary literature in physiology, nephrology, and biochemistry was conducted, focusing on mechanisms of potassium homeostasis and its interaction with metabolic pathways.

Results: Potassium is central to maintaining electrochemical gradients through Na⁺/K⁺-ATPase activity, a major consumer of cellular ATP. It modulates enzyme function, facilitates nutrient transport, and contributes to acid–base equilibrium. During metabolic acidosis, potassium shifts from the intracellular to extracellular compartment, impairing enzyme activity and metabolic efficiency. In exercise, transient potassium efflux from skeletal muscle increases extracellular potassium concentration, necessitating ATP-dependent restoration via Na⁺/K⁺-ATPase. Hyperkalemia disrupts membrane excitability, impairs metabolic processes, and is associated with systemic dysfunction, particularly in renal disease.

Conclusion: Potassium plays an integral role in metabolism by linking ionic homeostasis with energy production and cellular function. Disruptions in potassium balance, especially hyperkalemia, have significant metabolic and clinical consequences, underscoring the importance of precise regulatory mechanisms.